Paget’s Disease of the Bone
What is Paget’s disease of bone?
Paget’s disease of bone is a focal disorder of the bone characterized by an accelerated rate of bone remodeling, resulting in overgrowth of bone at single or multiple sites. This, in turn, affects the integrity and strength of the bone. The commonly affected bones are the skull, spine, pelvis, and lower extremity long bones.
Genetic and environmental factors are thought to contribute to the occurrence of the disease. Paget’s disease of the bone may develop sporadically, and 12 to 40% of the cases are familial.
Most of the patients with this condition are asymptomatic.
Symptoms arise due to
- Pain in the affected bone or the bony overgrowth and deformities in affected areas like osteoarthritis or nerve impingement.
- Bone deformity
- Fractures
- Bone tumors
- Radiculopathy – due to nerve compression
- Hearing loss
- Headache
Dr Reena Thomas will help diagnose this condition by performing a comprehensive medical evaluation and physical examination. She will order blood tests and urine studies to evaluate increased bone turnover. She will arrange for you to have plain X-rays of the affected bones and bone scintigraphy (bone radionuclide scans). She may order additional imaging like CT or MRI scans to evaluate unusual bony lesions and look for cancer. She may arrange for you to have a bone biopsy if there are bony lesions that are suspicious of cancer.
The goal of the treatment is to ease the pain from the disease, reduce the rate of bone remodeling, and slow disease progression.
Dr Reena Thomas will review the results of all the tests and imaging with you. Treatment is indicated for patients who are symptomatic with significant biochemical abnormalities or radiological evidence of disease as well as in asymptomatic individuals with Paget’s disease of the bone who are at risk for future complications and have active disease or if surgery is planned at an active pagetic site.
Dr Thomas will discuss the different medications used to treat Paget’s disease of the bone with you and explore their benefits, risks, and side effects. She will recommend calcium, phosphorous, and vitamin D supplementation.
Long-term follow-up for Paget’s disease is necessary to monitor the activity of the disease and the treatment. During your follow-up visits, Dr Thomas will perform a comprehensive medical evaluation, regular blood tests, and imaging to monitor the activity of the disease and side effects of the medications.
At a Glance
Dr. Reena Thomas, MD
- Dual American board-certified endocrinologist
- Author of numerous academic and clinic research
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